New "Morning After" Pill Can Work For Five Days

Plan B, also known as "the morning after" pill could be facing some serious competition. A new contraceptive drug — already available in Europe — has been shown to prevent pregnancy up to five days after unprotected sex. Houston women participated in the clinical trials, and FDA officials will review the results today in Washington, D.C. KUHF health science and technology reporter Carrie Feibel has more.
The new drug is called ulipristal and it works in a similar way to Plan B. They both block ovulation if taken a few days after unprotected intercourse. But ulipristal has some advantages over Plan B. Dr. Paul Fine is a professor at Baylor College of Medicine and co-authored two recent studies of the drug.

“It really works the same way as Plan B works by inhibiting ovulation but it does so for longer. Whereas Plan B is effective three days after unprotected intercourse, ulipristal is effective five days after unprotected intercourse. It gives a woman an extra two days of protection.”

One of the studies indicated that ulipristal could also be better than Plan B at preventing unwanted pregnancies.

“If the woman happens to be in the immediate 24-hour period prior to ovulation, plan B does not work. It works no better in studies than a sugar pill. Ulipristal very effectively prevents ovulation even the day before expected ovulation which makes it a more effective drug, in addition to lasting longer.”

Fine is medical director of Planned Parenthood of Houston and Southeast Texas. Hundreds of women were enrolled there for the studies of ulipristal. I asked the clinical research director, Melissa Farrell, why women might run out of time to use Plan B, and why they might go a few days before acting after unprotected sex.

“For some of them, it’s child care. Some of them were in school. Some of them had weird hours with their work. Some of them, you know it was ‘Well, now that I’ve started thinking about it I’m really concerned and it took me a couple of days to get to the point where I think I want to do something, and — or take something.’ Some people that’s just their decision making process, they take longer to decide than others.”

A French pharmaceutical company, HRA Pharma, paid for the two studies. Today an advisory committee at the FDA will review the data, and Dr. Fine could be called upon to speak.

“I can’t predict exactly how the FDA might act. We’re certainly in a more reproductive choice friendly administration now than we were under the Bush administration. But generally the FDA goes along with the recommendation of the advisory committee and does it fairly rapidly. So the American women could see this drug available as early as later this summer.”

That would be one possibility. But the FDA decision makers have, at times, ignored their own advisors. That’s what happened with Plan B. The advisory committee recommended in 2003 that the drug could be sold without a prescription. But it took two and a half years and Congressional pressure before the FDA agreed to that use.

For now, the company just wants ulipristal to be available by prescription. In Europe, the drug is called “ellaOne” and could have a similar name if sold here. Fine says it would be a good addition to U.S. pharmacies.

“If my daughter had a pill to keep in her medicine cabinet for emergency contraception, I would want it to be ulipristal, rather than Plan B.”

Abortion opponents disliked Plan B and many are already criticizing ulipristal, saying it can cause abortions. Fine says that’s incorrect — if an egg is already fertilized, the drug won’t stop a pregnancy.

Fine says most people are surprised to learn that Planned Parenthood participates in medical research. The Houston location is currently part of 11 clinical trials. Some are for new types of contraception, like a new skin patch, and others are evaluating easier ways to test for sexually transmitted diseases.

From the KUHF Health Science and Technology desk, I’m Carrie Feibel.
Bio photo of Carrie Feibel

Carrie Feibel

Health & Science Reporter

Carrie Feibel is KUHF's health and science reporter. She comes to Houston Public Radio after ten years as a print reporter...